Motor Neuron Model

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Motor Neurone Disease is a progressive neurodegenerative disorder of the anterior horn cells (lower motor neurons) and upper motor neurons of the cerebral cortex (Reeves & Swenson 2008). This gradually affects muscle strength, tone and muscle mass (Huether & McCance 2008). There are a number of different forms of the disease, including Amyotrophic Lateral Sclerosis, Primary Lateral Sclerosis, Progressive Muscular Atrophy and Progressive Bulbar Palsy (Bromberg 2015). These conditions have characteristics of overall muscle weakness with either lower motor signs such as, decreased reflexes and atrophy or upper motor neuron signs including, increased reflexes and spasticity (Reeves and Swenson, 2008). Yet, amyotrophic lateral sclerosis is the only …show more content…
Thus, the trajectory model was created, as this nursing model refers to, “The course of a chronical disease in its different stages and phases”. Three illness trajectories are known to the health care system, particularly palliative care regarding progressive chronic illnesses. These consist of, short period of evident decline, long term limitations with intermittent serious episodes and prolonged dwindling (Murray et al., 2005). Motor neurone disease is a progressive disease, thus prolonged dwindling is the suitable model for this illness. According to the Palliative Medicine text book prolonged dwindling consists of, “progressive disability from an already low baseline to cognitive and/or physical functioning” (Walsh et al., 2009). Due to this disease patients will gradually lose functional ability, resulting in declining social and physical events. The illness trajectory for motor neurone disease may be long and involve prolonged periods of support due to the decrease of function, lack of activity and involvement (Ferrell & Coyle 2006). Although, this trajectory may not prolong as a result of death from an acute event such as respiratory failure or chocking as dysphagia is common (Mandal …show more content…
Sharon had noticed a couple years ago, trouble gripping doors handles, difficulties opening bottles and had several tripping accidents displaying both upper and lower limb weakness. She was admitted to the medical ward following, increasing falls at home, speech distortion, swallowing difficulties and shortness of breath. In regards to her current symptoms, it is evident her ALS has progressed and is becoming a lot more difficult to manage. Sharon’s occupation as a teacher requires effective communication and physical health, thus becomes extremely difficult with altered speech and muscle weakness. Therefore, due to the disease progressing, Sharon will be unable to attend work as her physical and emotional ability has declined. In addition, will not be able to attend to George, her children Tom and Sophie or personal needs independently. Therefore, her career, financial income, family life and normal routine will be altered enormously. Experiencing these losses may be overwhelming, confusing or mentally too much, leading to an alteration of Sharon’s mental state. Which could result in disengagement in activities and family interactions, as well as isolation (Pagnini & Castelnuonvo 2016). A number of studies has found depression to be correlated to suffering, hopelessness, accelerated death and social
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